阳和汤联合唑来膦酸治疗阳虚寒凝型乳腺癌骨转移30例

Clinical effect of Yanghe decoction combined with zoledronic acid in treatment of breast cancer bone metastasis with Yang deficiency and cold congelation:An analysis of 30 cases

目的:观察阳和汤联合唑来膦酸治疗阳虚寒凝型乳腺癌骨转移的临床疗效及安全性。方法:将60例阳虚寒凝型乳腺癌骨转移患者随机分为治疗组和对照组,每组各30例。对照组给予唑来膦酸注射液治疗,治疗组在对照组基础上加用阳和汤治疗。观察2组的癌痛疗效、生活质量、数字分级法(NRS)评分、中医证候积分、骨代谢指标[血钙、血清骨代谢标志物碱性磷酸酶(ALP)、I型胶原N末端肽(NTX)水平]以及不良反应。结果:骨转移癌痛总有效率治疗组为73.4%(22/30),对照组为60.0%(18/30);生活质量总有效率治疗组为86.7%(26/30),对照组为73.3%(22/30),2组比较,差异均有统计学意义(P<0.05)。治疗组NRS评分、中医证候积分治疗前后组内比较及治疗后与对照组比较,2组ALP、NTX水平治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P<0.05或P<0.01)。2组血钙水平、不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:阳和汤可以作为阳虚寒凝型乳腺癌骨转移患者的辅助治疗手段,值得临床推广应用。

Objective:To investigate the clinical effect and safety of Yanghe decoction combined with zoledronic acid in the treatment of breast cancer bone metastasis with Yang deficiency and cold congelation.Methods:A total of 60 patients with breast cancer bone metastasis with Yang deficiency and cold congelation were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the treatment group were given zoledronic acid injection,and those in the treatment group were given Yanghe decoction in addition to the treatment in the control group.The two groups were observed in terms of treatment outcome of cancer pain,quality of life,numerical rating scale(NRS)score,traditional Chinese medicine(TCM)syndrome score,bone metabolism markers[blood calcium level and the serum levels of alkaline phosphatase(ALP)and N-telopeptide of type I collagen(NTX)],and adverse reactions.Results:There were significant differences between the treatment group and the control group in the overall response rate of bone metastatic cancer pain[73.4%(22/30)vs 60.0%(18/30),P<0.05]and the overall response rate of quality of life[86.7%(26/30)vs 73.3%(22/30),P<0.05].After treatment,the treatment group had significant changes in NRS score and TCM syndrome score and both groups had significant changes in the levels of ALP and NTX,and there were significant differences in these indices between the two groups after treatment(P<0.05 or P<0.01).There were no significant differences in blood calcium level and the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Yanghe decoction can be used as the adjuvant therapy for patients with breast cancer bone metastasis with Yang deficiency and cold congelation and thus holds promise for clinical application.